Bibliography

Introduction Anderson, Chris. “HHS Renews Push to Enroll People in Pre-Existing Condition Insurance Plan.” Healthcare Finance News. http://www.healthcarefinancenews.com/news/hhs-renews-push-enroll-people-pre-existing-condition-insurance-plan, February 11, 2011.

CBS News/New York Times Poll. “The Debate Over Health Care Reform.” CBSNEWS.com. http://www.cbsnews.com/stories/2009/07/29/politics/ main5196340.shtml, 2009.

Masiye, Felix et al. Removal of User Fees at Primary Health Care Facilities in Zambia. Luska, Zambia: University of Zambia, Department of Economics, 2008.

Parks, Dave. “Dying to Live: Following Transplant, Every Day is a Miracle.” Birmingham (AL) News, November 16, 2004.

———. “Into the Heart of the AIDS War Zone: Critical State for a Rural Hospital.” Birmingham (AL) News, March 15, 2005.

Statistical Abstract of the United States. National Health Expenditures. Washington, DC: U.S. Census Bureau, 2011.

TransplantLiving.org. “Financing a Transplant.” United Network for Organ Sharing. http://www.transplantliving.org/beforethetransplant/finance/ costs.aspx, 2011.

War on Reform: New Law Faces Legal, Political Attacks

148

Chapter 1 BarackObama.com. “Barack Obama and Joe Biden’s Plan to Lower Health Care Costs and Ensure Affordable, Accessible Health Coverage for All.” 2010.

BCBS.com. “History of Blue Cross Blue Shield.” BlueCross BlueShield Association. http://www.bcbs.com/about/history/.

Corning, Peter A. “The Evolution of Medicare.” Social Security Administration. http://www.ssa.gov/history/corning.html, 1969.

KFF.org. “Glossary of Key Health Reform Terms.” Henry J. Kaiser Family Foundation. http://www.kff.org/healthreform/upload/7909.pdf, 2008.

———. “Summary of New Health Care Reform Law.” Henry J. Kaiser Family Foundation. http://www.kff.org/healthreform/8061.cfm, 2010.

———. “The Uninsured: A Primer.” Henry J. Kaiser Family Foundation. http://www.kff.org/uninsured/7451.cfm, 2009.

Meyer, Bill. “National Health Care Debate Goes Back to Theodore Roosevelt Plan in 1912.” Cleveland Plain Dealer. http://www.cleveland.com/ nation/index.ssf/2009/08/national_health_care_debate_ha.html, 2009.

Montopoli, Brian. “White House Releases Letter From Cancer Patient Natoma Canfield.” CBSNews.com. http://www.cbsnews.com/ 8301-503544_162-6267519-503544.html, March 4, 2010.

OpenCongress.org. “H.R. 3590 – Patient Protection and Affordable Care Act, Official Summary.” Sunlight Foundation. http://www.opencongress.org/ bill/111-h3590/show, 2010.

Reinhardt, Uwe E. “The Perennial Quest to Lower Health Care Spending.” New York Times. http://economix.blogs.nytimes.com/2010/09/24/ the-perennial-quest-to-lower-health-care-spending/, September 24, 2010.

RPC.Senate.gov. “H.R. 3590: The Quality, Affordable Health Care for All Americans Act.” Senate Republican Policy Committee, 2009.

VA.gov. “VA History in Brief.” U.S. Department of Veterans Affairs. http://www.va.gov/opa/publications/archives/docs/history_in_brief.pdf

White House. Remarks of President Barack Obama on Health Insurance Reform. Washington, DC: Office of the Press Secretary, 2010.

Wolffe, Richard. Revival: The Struggle for Survival Inside the Obama White House. New York, NY: Crown, 2010.

Health Care Reform Simplified

149

Chapter 2 Armstrong, Drew. “McDonald’s, 29 Other Firms Get Health Care Coverage Waivers.” Bloomberg Business News, October 7, 2010.

Brudereck, Jason. “Understanding Health Care Reform Phase One.” Reading Eagle (PA), September 23, 2010.

Center for Medicare & Medicaid Services. Closing the Prescription Drug Coverage Gap. Washington, DC: U.S. Department of Health & Human Services, 2010.

Cutter, Stephanie. Voices of Health Care Reform: James’s Story. Washington, DC: White House Office of the Press Secretary, 2011.

Goldstein, Amy. “Study: 129 Million Have Pre-Existing Conditions.” Washington Post, January 18, 2011.

HealthCare.gov. “A New Day for American Consumers.” U.S. Department of Health & Human Services. http://www.healthcare.gov/news/factsheets/ overview.html, 2010.

———. “New Medicare Benefits for 2011.” U.S. Department of Health & Human Services. http://www.healthcare.gov/news/factsheets/ new_medicare_benefits.html, 2011.

———. “New Plan Options for Federally Administered Pre-Existing Condition Insurance Plan in 2011.” U.S. Department of Health & Human Services. http://www.healthcare.gov/news/factsheets/ new_plan_options_2011.html, 2011.

Hoover, Kent. “Uncertainty Surrounds Health Care Repeal.” Business Journal of Portland, January 28, 2011.

How, Sabrina et al. Scoring a Healthy Future: The Commonwealth Fund Scorecard on Child Health System Performance, 2011. New York, NY: The Commonwealth Fund, 2011.

KFF.org. “Expanding Medicaid to Low-Income Childless Adults under Health Reform: Key Lessons from State Experiences.” Henry J. Kaiser Family Foundation. http://www.kff.org/medicaid/upload/8087.pdf, 2010.

Kliff, Sarah and J. Lester Feder. “Child-Only Health Plans Endangered.” Politico.com. http://www.politico.com/news/stories/0111/48299.html, 2011.

Kumar, Kavita. “Tanning Owners Do Slow Burn Over Tax.” St. Louis Post-Dispatch, July 1, 2010.

War on Reform: New Law Faces Legal, Political Attacks

150

NCSL.org. “Covering Young Adults Through Their Parents’ or Guardians’ Health Policy.” National Conference of State Legislatures. http://www.ncsl.org/default.aspx?tabid=14497, 2010.

O’Brien, James. “Health Discount Scams Targeting Those Seeking Low-Cost Insurance.” WalletPop.com. http://www.walletpop.com/2011/03/07/ health-discount-scams-targeting-those-seeking-low-cost-insurance/, March 7, 2011.

Perera, Isabela. State by State Numbers—Who is Vulnerable if the Affordable Care Act is Dismantled. East Lansing, MI: States News Service, 2011.

Roan, Shari. “Indoor Tanning May Be Addictive.” Los Angeles Times, April 20, 2010.

RWJF.org. “Small Business Tax Credits.” Robert Wood Johnson Foundation. http://www.rwjf.org/coverage/product.jsp?id=71700, 2011.

Saint Louis, Catherine. “You’re Going to Pay for That Tan.” New York Times, December 22, 2009.

Seltz, Rhonda. “Insurance Companies Shun Healthy Kids.” Roanoke Times, December 20, 2010.

Suchetka, Diane. “Keeping Up With Health Care Reform.” Cleveland Plain Dealer, February 7, 2011.

Vasely, Rebecca. “High Risk, High Demand; $5 Billion Pool Opening in Some States.” Modern Healthcare, July 26, 2010.

———. “Ready to Jump In? States Advancing Plans for High-Risk Insurance Pools, But Not Everyone is Ready—or Willing—to Make the Dive.” Modern Healthcare, May 31, 2010.

Yin, Sandra. Enrollees in High-Risk Insurance Pools Double to 10,000. Washington, DC: FierceMarkets Inc., 2011.

Chapter 3 Adamy, Janet. “McDonald’s May Drop Health Plan.” Wall Street Journal. http://online.wsj.com/article/SB10001424052748703431604575522413101063070.html, 2010.

Chaikind, Hinda and Chris L. Peterson. Individual Mandate and Related Information Under PPACA. Washington, DC: Congressional Research Service, 2010.

Health Care Reform Simplified

151

CommonwealthFund.org. “New Report: Individual Health Insurance Market Failing Consumers.” The Commonwealth Fund. http://www.commonwealthfund.org/Content/News/News-Releases/2009/Jul/New-Report-Individual-Health-Insurance-Market- Failing-Consumers.aspx, 2009.

HarrisInteractive.com. “Individual Mandate in Health Care Reform Law Still Widely Unpopular: Poll.” Harris Interactive/HealthDay poll. http://www.harrisinteractive.com/NewsRoom/PressReleases/tabid/446/ mid/1506/articleId/704/ctl/ReadCustom%20Default/Default.aspx, 2011.

HealthCare.gov. “Affordable Care Act and Immunization.” U.S. Department of Health & Human Services. http://www.healthcare.gov/news/factsheets/ affordable_care_act_immunization.html, 2010.

———. “The Affordable Care Act: Protecting Consumers and Putting Patients Back in Charge of Their Care.” U.S. Department of Health & Human Services. http://www.healthcare.gov/news/factsheets/ protectconsumers_factsheet072210.pdf, 2010.

———. “Community Health Centers and the Affordable Care Act.” U.S. Department of Health & Human Services. http://www.healthcare.gov/news/ factsheets/increasing_access_.html, 2010.

———. “Health Insurance Exchanges: State Planning and Establishment Grants.” U.S. Department of Health & Human Services. http://www.healthcare.gov/news/factsheets/esthealthinsurexch.html, 2011.

———. “Keeping the Health Plan You Have.” U.S. Department of Health & Human Services. http://www.healthcare.gov/news/factsheets/ keeping_the_health_plan_you_have_grandfathered.html, 2010.

———. “Preventive Services Covered Under the Affordable Care Act.” U.S. Department of Health & Human Services. http://www.healthcare.gov/ law/about/provisions/services/lists.html, 2011.

KFF.org. “Access to Abortion Coverage and Health Reform.” Henry J. Kaiser Family Foundation. http://www.kff.org/healthreform/upload/8021.pdf, 2010.

———. “Health Reform Subsidy Calculator.” Henry J. Kaiser Family Foundation. http://healthreform.kff.org/SubsidyCalculator.aspx, 2011.

Lischko, Amy M. et al. The Massachusetts Commonwealth Health Insurance Connector: Structure and Function. New York, NY: The Commonwealth Fund, 2009.

War on Reform: New Law Faces Legal, Political Attacks

152

Pear, Robert. “Long-Term Care Program Needs Changes.” New York Times. February 21, 2011.

Wisconsin.gov. “Wisconsin Health Insurance Exchange prototype.” State of Wisconsin. https://exchange.wisconsin.gov/, 2011.

Chapter 4 CNN.com. “What Health Care Reform Means for Your Business.” http://money.cnn.com/2010/03/22/smallbusiness/ small_business_health_reform/, March 22, 2010.

HealthAffairs.org. “Health Policy Brief: Small Business Tax Credits.” Robert Wood Johnson Foundation. http://www.healthaffairs.org/healthpolicybriefs/ brief_pdfs/healthpolicybrief_38.pdf, 2011.

HealthCare.gov. “The Affordable Care Act’s Early Retiree Reinsurance Program.” U.S. Department of Health & Human Services. http://www.healthcare.gov/news/factsheets/ early_retiree_reinsurance_program.html, 2010.

———. “Increasing Choice and Saving Money for Small Business.” U.S. Department of Health & Human Services. http://www.healthcare.gov/news/ factsheets/increasing_choice_and_saving_money_for_small_businesses.html, 2010.

IRS.gov. “Small Business Health Care Tax Credit: Frequently Asked Questions.” Internal Revenue Service. http://www.irs.gov/newsroom/ article/0,,id=220839,00.html, 2010.

———. “Small Business Tax Credit for Small Employers.” Internal Revenue Service. http://www.irs.gov/newsroom/article/0,,id=223666,00.html, 2011.

Leonard, Bill. Does the Health Reform Law Really Create an Employer Mandate? Alexandria, VA: Society for Human Resource Management, 2010.

O’Connor, James T. “Patient Protection and Affordable Care Act: Implications of Status as a Grandfathered Plan.” Benefits Quarterly, 2011;27(1):12-7.

White House. Fact Sheet: Small Business Health Care Tax Credit. Washington, DC: Office of the Press Secretary, 2010.

Health Care Reform Simplified

153

Chapter 5 AHIP.org. “AHIP Statement on Health Care Reform Legislation.” America’s Health Insurance Plans. http://www.ahip.org/content/ pressrelease.aspx?docid=29767, 2010.

CMS/Office of Legislation. Medicare “Accountable Care Organizations” Shared Savings Program—New Section 1899 of Title XVIII. Washington, DC: Centers for Medicare & Medicaid Services, 2011.

CNN.com. “Health Care Coverage: Big Changes in 2012.” http://money.cnn.com/2011/03/10/news/economy/ health_insurance_changes_by_employers/index.htm, March 10, 2011.

Devers, Kelly and Robert Berenson. Can Accountable Care Organizations Improve the Value of Health Care by Solving the Cost and Quality Quandaries? Washington, DC: The Urban Institute, 2009.

Girion, Lisa. “Blue Cross Praised Employees Who Dropped Sick Policyholders, Lawmaker Says.” Los Angeles Times, June 17, 2009.

Inglehart, John K. “Assessing an ACO Prototype—Medicare’s Physician Group Practice Demonstration.” New England Journal of Medicine, Dec. 22, 2010. (10.1066/NEJMp1013896).

Jost, Timothy Stoltzfus. “Writing New Rules for Insurers—Progress on the Medical Loss Ratio.” New England Journal of Medicine, October 27, 2010. (10.1056/NEJMp1011717)

Reinhardt, Uwe E. “How Much Money Do Insurance Companies Make? A Primer.” New York Times. http://economix.blogs.nytimes.com/2009/09/25/ how-much-money-do-insurance-companies-make-a-primer/, September 25, 2009.

———. “Is ‘Community Rating’ in Health Insurance Fair?” New York Times. http://economix.blogs.nytimes.com/2010/01/01/ is-community-rating-in-health-insurance-fair/, January 1, 2010.

———. “On Health Care, the Devil’s in the Details.” New York Times. http://economix.blogs.nytimes.com/2010/09/03/ on-health-care-the-devils-in-the-details/, September 3, 2010.

———. “What Portion of Premiums Should Insurers Pay Our in Benefits?” New York Times. http://economix.blogs.nytimes.com/2009/10/02/ what-portion-of-premiums-should-insurers-pay-out-in-benefits/, October 2, 2009.

War on Reform: New Law Faces Legal, Political Attacks

154

Stanton, M.W. “The High Concentration of U.S. Health Care Expenditures.” Agency for Healthcare Research and Quality. http://www.ahrq.gov/research/ ria19/expendria.htm, 2006.

Chapter 6 AAMC.org. “AAMC Releases New Physician Shortage Estimates Post-Reform.” Association of American Medical Colleges. https://www.aamc.org/ newsroom/newsreleases/2010/150570/100930.html, 2010.

Andrews, Michelle. “Some Medicare Practices Move to Monthly Membership Fees for Patients.” KaiserHealthNews.org. http://www.kaiserhealthnews.org/features/insuring-your-health/ michelle-andrews-on-subscribing-to-primary-care.aspx, 2011.

Axon, R. Neal and Mark V. Williams. “Hospital Readmission as an Accountability Measure.” Journal of the American Medical Association, February 2, 2011; 305(5):504-505.

Berkowitz, Scott A. “Accountable Care Organizations at Academic Medical Centers.” New England Journal of Medicine, February 2, 2011. (10.1056/NEJMp1100076)

Center for Policy Research. Innovations in Reducing Preventable Hospital Admissions, Readmissions, and Emergency Room Use. Washington, DC: America’s Health Insurance Plans, 2010.

Connors, Elenora E. and Lawrence O. Gostin. “Health Care Reform—A Historic Moment in U.S. Policy.” Journal of the American Medical Association, June 23, 2010; 303(24); 2521-2522.

Fairman, Julia A. et al. “Broadening the Scope of Nursing Practice.” New England Journal of Medicine, December 15, 2010. (10.1056/NEJMp1012121)

Hall, Mark A. “Rethinking Safety-Net Access for the Uninsured.” New England Journal of Medicine, December 10, 2010. (10.1056/NEJMp1011502)

HealthCare.gov. “Creating Jobs and Increasing the Number of Primary Care Providers.” U.S. Department of Health & Human Services. http://www.healthcare.gov/news/factsheets/ creating_jobs_and_increasing_primary_care_providers.html, 2010.

Jha, Ashish K. “Meaningful Use of Electronic Health Records.” Journal of the American Medical Association, October 20, 2010; 304(15); 1709-1710.

Health Care Reform Simplified

155

Katz, Mitchell H. “Future of the Safety Net Under Health Reform.” Journal of the American Medical Association, August 11, 2010; 304(6); 679-680.

Kohn, Linda T. et al. To Err is Human: Building a Safer Health System. Washington, DC: National Academy Press, 2000.

Laraque, Danielle and Calvin C.J. Sia. “Health Care Reform and the Opportunity to Implement a Family-Centered Medical Home for Children.” Journal of the American Medical Association, June 16, 2010; 303(23); 2407-2408

Leighton, Ku et al. “The States’ Next Challenge—Securing Primary Care for Expanded Medicaid Populations.” New England Journal of Medicine. January 26, 2011. (10.1056/NEJMp1011623)

McDermott, Jim. “Harnessing Our Opportunity to Make Primary Care Sustainable.” New England Journal of Medicine, January 19, 2011. (10.1056/NEJMp1014256)

Richman, Barak D. and Kevin A Schulman. “A Cautious Path Forward on Accountable Care Organizations.” Journal of the American Medical Association, February 9, 2011; 305(6):602-603.

Chapter 7 Chattopadhyay, Arpita and Andrew B. Bindman. “Linking a Comprehensive Payment Model to Comprehensive Care of Frail Elderly Patients.” Journal of the American Medical Association, November 3, 2010; 304(17): 1948-1949.

HealthCare.gov. “Medicare Beneficiary Savings and the Affordable Care Act.” U.S. Department of Health & Human Services. http://www.healthcare.gov/center/reports/affordablecareact.html, 2010.

KFF.org. “Medicaid and Children’s Health Insurance Program Provisions in the New Health Reform Law.” Henry J. Kaiser Family Foundation. http://www.kff.org/healthreform/7952.cfm, 2010.

———. “Summary of Key Changes to Medicare in 2010 Health Reform Law.” Henry J. Kaiser Family Foundation. http://www.kff.org/healthreform/ upload/7948-02.pdf, 2010.

Pizzi, Richard. “Florida Long-Term Care Providers Issue Warning on Medicaid, Medicare Cuts.” HealthCare Finance News. http://www.healthcarefinancenews.com/news/ florida-long-term-care-providers-issue-warning-medicaid-medicare-cuts, 2010.

War on Reform: New Law Faces Legal, Political Attacks

156

Reinhardt, Uwe E. “How Medicare Pays Physicians.” New York Times. http://economix.blogs.nytimes.com/2010/12/03/how-medicare-pays-physicians/, December 3, 2010.

———. “The Annual Drama of the ‘Doc Fix.’” New York Times. http://economix.blogs.nytimes.com/2010/12/17/ the-annual-drama-of-the-doc-fix/, December 17, 2010.

Smith, Donna. “Q+A: How Does Healthcare Overhaul Affect Medicare?” Reuters. http://www.reuters.com/article/2010/03/22/ us-usa-healthcare-medicare-idUSTRE62J1FS20100322, March 22, 2010.

Sommers, Benjamin D. and Arnold M. Epstein. “Medicaid Expansion—The Soft Underbelly of Health Care Reform?” New England Journal of Medicine, November 24, 2010. (10.1056/NEJMp1010866)

Chapter 8 AHRQ.gov. “Low Health Literacy Linked to Higher Risk of Death and More Emergency Room Visits and Hospitalizations.” Agency for Healthcare Research and Quality. http://www.ahrq.gov/news/press/pr2011/ lowhlitpr.htm, 2011.

Boodman, Sandra G. “Helping Patients Understand Their Medical Treatment.” KaiserHealthNews.org. http://www.kaiserhealthnews.org/ Stories/2011/March/01/Health-Literacy-Understanding-Medical-Treatment.aspx, March 1, 2011.

CDC.gov. “U.S. Obesity Trends by State 1985–2009.” Centers for Disease Control. http://www.cdc.gov/obesity/data/trends.html, 2010.

Drummond, Kate. “Hidden Health Care Clause: Menu Labels Go National.” AolNews.com. http://www.aolnews.com/2010/03/22/ hidden-health-care-clause-menu-labels-go-national/, March 22, 2010.

Health.gov. “National Action Plan to Improve Health Literacy.” U.S. Department of Health & Human Services. http://www.health.gov/ communication/HLActionPlan/, 2010.

HHS.gov. “HHS Releases National Plan to Improve Health Literacy.” U.S. Department of Health & Human Services. http://www.hhs.gov/ash/news/ 20100527.html, 2010.

———. “Medicare Payment and Volume Data.” U.S. Department of Health & Human Services. http://www.hospitalcompare.hhs.gov, 2011.

Health Care Reform Simplified

157

Medicare.gov. “Home Health Compare.” U.S. Department of Health & Human Services. http://www.medicare.gov/HomeHealthCompare/ search.aspx, 2011.

Somers, Stephen A. and Roopa Mahadevan. Health Literacy Implications of the Affordable Care Act. Hampton, NJ: Center for Health Care Strategies Inc., 2010.

Vaida, Bara. “Calorie Labeling for Restaurant Recommendations Coming Soon.” KaiserHealthNews.org. http://www.kaiserhealthnews.org/Stories/2011/ March/07/menu-labeling.aspx, March 6, 2011.

WCSR.com. “FDA Expediting Menu Labeling Implementation and Enforcement.” Womble Carlyle Sandridge & Rice, PLLC. http://www.wcsr.com/client-alerts/fda-expediting-menu-labeling-implementation-and-enforcement, 2010.

Chapter 9 Deloitte.com. “Prescription for Change ‘Filled.’ Tax Provisions in the Patient Protection and Affordable Care Act.” Deloitte Development LLC. http://www.deloitte.com/view/en_US/us/Services/tax/ 112a52f1b5277210VgnVCM100000ba42f00aRCRD.htm, 2010.

Elmendorf, Douglas W. “Testimony on Last Year’s Health Care Legislation.” Congressional Budget Office. http://cboblog.cbo.gov/?p=2088, 2011.

Foster, Richard S. “The Estimated Effect of the Affordable Care Act on Medicare and Medicaid Outlays and Total National Health Care Expenditures. Testimony before the House Committee on the Budget.” U.S. House of Representatives Committee on the Budget. http://budget.house.gov/UploadedFiles/fostertestimony1262011.pdf, 2011.

HealthCare.gov. “Centers for Medicare & Medicaid Services Enhance Efforts to Prevent and Fight Health Care Fraud.” U.S. Department of Health & Human Services. http://www.healthcare.gov/news/factsheets/ prevent_health_care_fraud.html, 2010.

Holahan, John and L. Blumberg. “Will Health Care Reform Increase the Deficit and National Debt?” The Urban Institute. http://www.rwjf.org/ healthpolicy/product.jsp?id=66768, 2010.

Nevius, Alistair. “Health Care Reform Reshapes Tax Code.” Journal of Accountancy, April 1, 2010.

War on Reform: New Law Faces Legal, Political Attacks

158

NPR.org. “Dollars for Docs.” National Public Radio. http://www.npr.org/ series/130598927/dollars-for-docs-how-pharma-money-influences-physician-prescriptions, 2010.

Pryde, Joan. “Health Care Reform: 13 Tax Changes on the Way.” Kiplinger.com. http://www.kiplinger.com/businessresource/forecast/ archive/health-care-reform-tax-hikes-on-the-way.html?si=1, 2010.

Waller Lansden Dortch & Davis LLP. “Follow the Money: Healthcare Reform Revenue Raising (Tax) Provisions.” http://www.wallerlaw.com/ articles/2010/03/23/follow-the-money-the-healthcare-reform-revenue-raising-tax-provisions, 2010.

Chapter 10 Blumberg, Linda J. “How Will the PPACA Impact Individual and Small Group Premiums in the Short and Long Term?” The Urban Institute. http://www.urban.org/uploadedpdf/412128-PPACA-impact.pdf, 2010.

CBO.gov. “Effects of Eliminating the Individual Mandate to Obtain Health Insurance.” Congressional Budget Office. http://www.cbo.gov/ftpdocs/ 113xx/doc11379/Eliminate_Individual_Mandate_06_16.pdf, 2010.

Goldstein, Amy and N.C. Aizenman. “As Health Care Law Turns 1, Supporters Using Occasion to Shape It’s Image.” Washington Post, March 22, 2011.

GOP.gov. “Repeal & Replace the Job Destroying Health Care Law.” The House Republican Conference. http://www.gop.gov/pledge/healthcare, 2011.

HealthCare.gov. “The Price of Repealing the Affordable Care Act.” U.S. Department of Health & Human Services. http://www.healthcare.gov/news/ factsheets/repealcosts.html, 2011.

Herring, Bradley. “An Economic Perspective on the Individual Mandate’s Severability from the ACA.” New England Journal of Medicine, February 23, 2011. (10.1056/NEJMpv1101519)

Hsiao, William C. “State-Based Single-Payer Health Care—A Solution for the United States?” New England Journal of Medicine, March 16 2011. (10.1056/NEJMp1100972)

JLBGHealth.com. “Judge Says NH Man Lacks Standing to Sue Over Health Care Reform.” J.L. Barnes Group. http://www.jlbghealth.com/blog/archives/ 963-Judge-says-NH-man-lacks-standing-to-sue-over-healthcare-reform.html, 2011.

Health Care Reform Simplified

159

Kenen, Joanne. “Experts Ponder ‘Plan B’ Options for the Individual Mandate.” Henry J. Kaiser Family Foundation. http://www.kaiserhealthnews.org/Stories/2010/December/17/ mandate-alternatives.aspx, December 17, 2010.

Kennedy, Kelly. “States Proceed on Health Care Law.” USA Today, February 18, 2011.

KFF.org. “Pop Quiz: Assessing Americans’ Familiarity with the Health Care Law.” Henry J. Kaiser Family Foundation. http://www.kff.org/healthreform/ upload/8148.pdf, 2011.

NCLS.org. “State Legislation and Actions Challenging Certain Health Reforms, 2011.” National Conference of State Legislatures. http://www.ncsl.org/?tabid=18906, 2011.

Oberlander, Jonathan. “Beyond Repeal—The Future of Health Care Reform.” New England Journal of Medicine, November 17, 2010. (10.1056/NEJMp1012779)

———. “Under Siege—The Individual Mandate for Health Insurance and Its Alternatives.” New England Journal of Medicine, February 16, 2011. (10.1056/NEJMp1101240)

Rutkow, Lainie and Stephen P. Teret. “Role of State Attorneys General in Health Policy.” Journal of the American Medical Association, September 22, 2010; 304(12):1377-1378.

TheHill.com. “Number of Healthcare Reform Law Waivers Climbs to Above 1,000.” The Hill. http://thehill.com/blogs/healthwatch/ health-reform-implementation/147715-number-of-healthcare-reform-law-waivers-climbs-above-1000, 2011.

Vermont.gov. “Vermont Blueprint for Health.” State of Vermont. http://hcr.vermont.gov/sites/hcr/files/final_annual_report_01_26_11.pdf, 2010.

Zelizer, Julian E. “The Real Threat to Health Care Reform.” CNN.com. http://articles.cnn.com/2010-12-20/opinion/zelizer.health.reform.threat_1_ health-care-republicans-policies?_s=PM:OPINION, December 20, 2010.

I

Index A Accountable care organizations

(ACOs) complicated issues, 89 cost and quality of care, 88 goal, 88 medical errors, 98 Medicare and Medicaid

Services, 89 Norton Healthcare, 89

Adverse selection, 49, 55

B BadgerCare Plus, 46

Bo-Tax, 31

Budget, 127 Cadillac insurance tax, 130 CLASS Act, 134 Congressional Budget Office, 127 drug companies paying new fees

in 2011, 131 health care costs, 127 Medicare savings, 133 Medicare tax, 129 private insurers in new annual

fees, 130 revenue sources, 134 tax for medical devices, 132

C Cadillac Insurance Tax, 130

Chain restaurants, 123

Children’s Health Insurance Program, 1, 7

CLASS Act, 134

Commonwealth Choice, 46

The Commonwealth Fund, 122

Community rating critics of, 82 limitation, 82 premium prices, 81 proponents of, 82 risk adjustment, 82

Community-based health centers, 102

Consolidated Omnibus Budget Reconciliation Act (COBRA), 6

Consumer-Owned and Orientated Plans (CO-OP), 87

Cover patients with pre-existing conditions, 142

D Defensive medicine, 142

Diagnostic related groups (DRGs), 6

Index

162

E Early Retiree Reinsurance Program, 71

applicants, 71 insurance exchanges, 73

Employer-sponsored health insurance, 67

Evidence-based practice, 101

Existing insurance plan, 60 Expand health savings accounts, 142

Extended Plan, 24

F, G Federal Reduced Cost Sharing, 46

Federal Tax Credit, 46

H Health Care Choice Act, 142

Health care law changes and challenges, 57 in 2010, 57 in 2011, 58 in 2012, 58 in 2013, 58 in 2014, 59 in 2018, 60

Health care premiums, 28

Health Care Reform, 1, 21 accountable care organizations, 1 adverse selection, 26 America’s health care system, 1 banned insurers, 29 expanded plan options for high-

risk exchanges, 23 Federal poverty level, 12 Hammurabi’s code, 3 health care insurance, 2 health care law initiatives, 12, 13 individual mandate and tax

penalties, 14 insurance guarantees for

children, 25 insurance rate, 28

Medicaid, 16 medical care costs, 5 Medicare, 5 Medicare Part D drug benefit, 30 new rules for insurance covering

workers, 15 Patient Protection and Affordable

Care Act of 2010, 21 political primer, 7 pre-existing conditions, 25 premium, 12 premium assistance tax credit/

premium subsidies, 12 2008 Presidential Campaign, 9 President Obama, 10, 11 preventive care and quality of

care, 17 private insurance, 16 provisions, 19 small business tax credit, 12 successful new health care law, 22 tanning services, 31 tax credit for smaller

businesses, 33 temporary exchanges with

high-risk people, 22 unisured people, 18 UV radiation exposure during

indoor tanning, 32 World War II, 2

Blue Cross and Blue Shield plans, 3

Kerr-Mills Act, 4 Veterans Affairs, 4

young adults up to age 26 on parents’ policies, 26

Health Information Technology for Economic and Clinical Health Act (HITECH), 96

Health Literacy Implications of the Affordable Care Act, 118

Health Maintenance Organization (HMO), 109

Health Maintenance Organization with Point-of-Service Option (HMO-POS), 109

Index

163

Health Savings Account Option, 24 Henry J. Kaiser Family Foundation, 122

I, J Individual and Family Insurance, 37

abortion coverage, 43 existing insurance plans, 37 income tax system, 54 individual mandate requirements

and penalties, 49 insurance exchanges, 40

benefits, 41 limitations, 41 Massachusetts insurance

exchange, 46 nationwide network, 40 poverty level, 42 uninsured people, 41 Wisconsin prototype, 43

long-term care insurance, 55 Mini-Med Insurance Plans, 39 pre-existing medical conditions, 51 rights to appeal, choose doctor,

and preventive care, 52 tax credit, 53

Individual mandate, 14 alternatives to the, 139 lawsuits against, 141 U.S. Supreme Court, 137

Info Overload, 117 communication chasm, 120 disclosure of financial ties with

doctors, 122 health literacy, 118 Internet, 117 nutritional labeling, 123 sources of information, 120

Insurance, 77 accountable care organizations, 88 community rating, 81 Co-Ops, 87 essential health benefits, 83 government, 81 guaranteed coverage, 80 medical loss ratio, 78 minimum essential coverage, 83

preventive care services, 84 for adults, 84 for children, 85 for women, 84

provisions, 77 state and federal regulations, 77

K Kerr-Mills Act, 5

L Legal and political challenges, 137, 147

alternatives to the individual mandate, 139

GOP success, 144 health care reform certainty, 145 health care reform with and

without mandates, 140 individual mandate, 137 lawsuits against individual

mandate, 141 opposing and implementing health

care reform, 144 republicans, 142 Ryan Plan, 143 state and federal levels, 137

M Massachusetts insurance exchange, 140

commonwealth care, 46 commonwealth choice, 47 connector, 46 criticism, 47 individual mandate, 49

McDonald’s Mini-Med Insurance Plans, 40

Medicaid, 16 Children’s Health Insurance

Program, 105 flexibility, 113 insurance coverage, 105 long-term care, 114 projected growth, 105 Standard for Eligibility, 112

Index

164

Medicaid’s Children’s Health Insurance Program (CHIP), 26

Medical errors, 91 accountable care organizations, 98 communications, 96 Community Health Centers, 102 coordination of care, 96 deadly toll by, 92 direct pay practices, 97 doctor shortages with surge of

patients, 99 evidence-based practice, 101 lowering hospital readmission

rates, 95 medical home, 96 National Strategy for Quality

Improvement in Health Care, 91

persistent problems, 91 primary care shortages, 100 safety net hospitals, 103

Medical home, 96

Medical liability reform, 142

Medical loss ratio, 38, 78

Medicare, 5, 14, 30 Advantage plans, 108

beneficiaries, 108 bonus program, 110 consumer protections, 111 types, 109

bidding process and cost, 110 insurance coverage, 105 projected growth, 105 quality improvement and control

costs, 106 savings, 133 tax, 129

Medicare Catastrophic Coverage Act, 6

Medicare fee-for-service programs, 95

Medicare Medical Savings Account (MSA), 110

Medicare Special Needs Plans (SNPs), 110

N, O Nutritional labeling

FDA regulations, 123 National Restaurant

Association, 124 obesity rates, 124 restaurants, 123

P, Q Patient Protection and Affordable

Care Act, 1, 14 Patient Protection and Affordable

Care Act of 2010 sources of information, 120

Physician Payments Sunshine provisions, 122

Preferred Provider Organization (PPO), 110

Private Fee-for-Service (PFFS), 110

Prohibit taxpayer funding of abortion, 143

R Risk adjustment, 82 Robert Wood Johnson

Foundation, 122

Ryan Plan, 143

S Safety net hospitals, 103

Single-payer system, 141

Small Business Options Program (SHOP), 70

Small businesses cost of health insurance per

hour, 62 counting on a tax credit, 63

employer’s costs, 64 IRS rules, 65 part-time workers, 63 qualification, 64

Index

165

insurance exchanges, 70 tax credits, 62 tax relief from big insurance

costs, 61

Standard Plan, 24

T Tax penalties, 66

large employers, 67 short of government guidelines, 67 small businesses, 66 subpar health insurance, 67

Tax Provisions in the Patient Protection and Affordable Care Act, 129

U U.S. Bureau of Labor Statistics, 62

V Vending machines, 123

Veterans Affairs (VA) care, 4

W, X, Y, Z Wellness Programs, 74

HIPAA rules, 75 incentives, 74

Wisconsin insurance exchange prototype

assistance, 45 family of four, 44 priorities, 44 64-year-old couple, 45 27-year-old woman, 45